不同血液净化方式对维持性血液透析患者的影响研究及效果分析

Study and Analysis of the Influence of Different Blood Purification Methods on Patients with Maintenance Hemodialysis

目的:分析不同血液净化方式对维持性血液透析(MHD)患者的微炎症、营养状态和生活质量的影响。方法:选取2012年10月-2017年6月来本院接受血液净化治疗的尿毒症患者100例作为研究对象,按照不同的治疗方式将其分为血液透析(HD)组(n=30)、血液透析滤过(HDF)组(n=35)和血液透析(HD)+血液灌流(HP)组(n=35),分析不同血液净化方式对维持性血液透析患者的影响。结果:治疗后HDF组及HD+HP组的微炎症和营养状态指标水平与治疗前比较均明显改善,其中Hb及ALB均明显升高,IL-6、CRP和β2-微球蛋白均明显降低,差异均有统计学意义(P<0.05);HD组与治疗前比较上述指标均无明显变化,差异均无统计学意义(P>0.05)。治疗后,HDF组及HD+HP组的微炎症和营养状态指标水平与HD组比较均明显改善,差异均有统计学意义(P<0.05);但HDF组和HD+HP组比较,差异均无统计学意义(P>0.05)。治疗后,HDF组和HD+HP组患者的各项生活质量评分与治疗前比较均有所提升,差异均有统计学意义(P<0.05);但HD组与治疗前比较,差异均无统计学意义(P>0.05)。治疗后HDF组及HD+HP组各项生活质量评分均明显高于HD组,差异均有统计学意义(P<0.05);而HD+HP组和HDF组间比较,差异均无统计学意义(P>0.05)。结论:维持性血液透析患者存在微炎症状态,开展HDF以及HD+HP治疗,可起到一定改善效果,有助于患者疾病转归,提升生活品质,值得进一步推广。

Objective：To analyze the effects of different blood purification methods on microinflammation, nutritional status and quality of life on patients with maintenance hemodialysis（MHD）.Method：A total of 100 patients with uremia who received blood purification treatment in our hospital from October 2012 to June 2017 were selected as the study objects.According to different treatment methods,they were divided into hemodialysis（HD） group（n=30）,hemodiafiltration（HDF） group（n=35） and hemodialysis（HD）＋hemoperfusion（HP） group（n=35）.The effects of different blood purification methods on patients with maintenance hemodialysis were analyzed.Result：After treatment,the levels of microinflammation and nutritional status in HDF and HD＋HP groups were significantly improved compared with those before treatment,the levels of Hb and ALB were significantly increased,while the levels of IL-6,CRP andβ_2-microglobulin were significantly decreased,the differences were statistically significant（P〈0.05）.There were no significant differences in the above indexes of HD group（P〉0.05）.After treatment,the quality of life scores of HDF group and HD ＋ HP group were significantly higher than those before treatment,the differences were statistically significant（P〈0.05）,but there were no significant differences in the above scores of HD group（P〉0.05）. After treatment,the scores of quality of life in HDF group and HD＋HP group were significantly higher than those in HD group,the differences were statistically significant（P〈0.05）,but there were no significant differences between HD＋HP group and HDF group（P〉0.05）.Conclusion：There is a microinflammatory state in MHD patients,and the treatment of HDF and HD＋HP can play a certain improvement effect,conducive to the prognosis of patients with disease and improve the quality of life,worthy of further promotion.